{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:10:09Z","timestamp":1784826609195,"version":"3.55.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Cefepime is an antibiotic commonly used to treat sepsis and is cleared by renal excretion. Cefepime dosing requires adjustment in patients with decreased kidney function and in those receiving continuous kidney replacement therapy (CKRT). We aimed to characterize cefepime PK in a diverse cohort of critically ill paediatric patients on CKRT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients were identified from an ongoing pharmacokinetic\/pharmacodynamic (PK\/PD) study of beta-lactam antibiotics, and were included if they had received at least two cefepime doses in the ICU and were on CKRT for at least 24 h. PK parameters were estimated using MwPharm++ with Bayesian estimation and a paediatric population PK model. Target attainment was assessed as time of free cefepime concentrations above minimum inhibitory concentration (fT\u200a&amp;gt;\u200a1\u00d7 or 4\u200a\u00d7\u200aMIC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seven patients were included in the study (ages 2 to 20 years). CKRT indications included liver failure (n\u200a=\u200a1), renal failure (n\u200a=\u200a4) and fluid overload (n\u200a=\u200a2). Total effluent flow rates ranged from 1833 to 3115 (mean 2603) mL\/1.73 m2\/h, while clearance was 2.11\u20133.70 (mean 3.0) L\/h\/70 kg. Effluent flows were lower, but clearance and fT\u200a&amp;gt;\u200aMIC were similar to paediatric data published previously. Using Pseudomonas aeruginosa MIC breakpoints, all patients had 100% of dosing interval above MIC, but only one had 100% of dosing interval above 4\u00d7 MIC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Since most patients failed to attain stringent targets of 100% fT\u200a&amp;gt;\u200a4\u00d7\u200a MIC, model-informed precision dosing may benefit such patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad192","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T11:27:37Z","timestamp":1689766057000},"page":"2140-2147","source":"Crossref","is-referenced-by-count":8,"title":["Cefepime pharmacokinetics in critically ill children and young adults undergoing continuous kidney replacement therapy"],"prefix":"10.1093","volume":"78","author":[{"given":"Kathryn","family":"Pavia","sequence":"first","affiliation":[{"name":"Division of Critical Care Medicine, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"},{"name":"Division of Clinical Pharmacology, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H Rhodes","family":"Hambrick","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"},{"name":"Division of Nephrology and Hypertension, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Paice","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"},{"name":"Division of Clinical Pharmacology, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tang","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieko","family":"Punt","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, University of Groningen , Groningen , The Netherlands"},{"name":"Medimatics , Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart L","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander A","family":"Vinks","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Cincinnati Children\u2019s Hospital Medical 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